Main Stage Presentations at Health Education England's national conference November 22, 2017, London, UK

1. Showcase, Celebrate, Share Progress
Nursing Associate National Conference

2. Professor Ian Cumming
Chief Executive, Health Education England

3. Philip Dunne, MP
Minister of State for Health

4. Simon Hough
Lived Experience Connector
Richard Sherwood
Trainee Nursing Associate
CHESHIRE AND WIRRAL PARTNERSHIP
Learning About Each Other

5. NURSING ASSOCIATE SCRUTINY GROUP
RECOMMENDATIONS and PROPOSALS

6. Aim of the group:
The ultimate aim of the group
was to ensure that the
implementation of Nursing
Associate role is supported by
rigorous oversight and scrutiny.
It provided a forum for open and
honest discussion; an
opportunity to dispel myths and
recognise where further
discussion is necessary.

7. Objectives:
1. Identify key challenges where further assurance
was needed
2. Improve stakeholder confidence in the Nursing
Associate programme
3. Seek appropriate academic advice as part of the
call for evidence approach that will imbue this
programme of work
4. Provide an opportunity to share learning and
intelligence and seek further information and
insight

8. Creation of the Group
Membership
4 core group meetings
4 regional meetings
Recommendations
The group used an iterative, action learning approach

9. Recommendations:
1. Defining the scope of Practice for the Nursing Associate
2. Accounting for the ‘Shape’ and ‘Nature’ of the Nursing
Workforce
3. Medicines Administration
4. Enhancing the Learning Experience for Trainee Nursing
Associates
5. Other Matters for Consideration Relating to Career
Progression and Ongoing Monitoring of the Cost-Benefits
and Impact of the Role of the Nursing Associate

10. 1. Defining the scope of practice
• Defined narrative for current
health and care workforce and
the public
• Clearly defined clinical
governance and assurance
arrangements in association
with NMC standards and
system regulators
requirements
• Separate medicines group
convened

11. 2. Accounting for the ‘shape’ and
nature of the workforce
• Responsibility and
accountability held by service
managers (Directors of
Nursing, Registered Care
Home managers) to determine
skill mix
• These managers should
remain alert to risks of covert
role expansion and
inappropriate role substitution

12. 3. Enhancing the trainee
experience
1. Recommended that all entrants should be prepared to QCF
Level 2 (literacy and numeracy) prior to commencement of
the programme
2. Employers and education providers provide appropriate
support and supervision for trainees
3. Quality of all placements is monitored
4. Development of a national Practice Assessment Document

13. 4. Other Matters for Consideration
1. APEL and progression
routes into NA and into RN
2. Registered Nursing
Associates participate in
coaching and supervision
3. HEE and NMC monitor
and map scope of role and
evaluate progress

14. 5. Medicines Group
Sector
rep
HEI
Patient
rep
NMC
ALBs
CQC

15. Who administers medicines now in health
and social care organisations?

16. Governance and Assurance
System Regulator
Employing
Organisation
Regulated
professional

17. Recommendations
This interim guidance
includes recommendations
on:
• Education and training
• Organisational level policy
• Safety critical medications
• Administration of medicines
via alternative routes
• Governance and assurance
September 2016
Who is it for?
Employers of Nursing Associates
Trainers/educators of Nursing
Associates
Supervisors of Nursing
Associates
Commissioners of Nursing
Associate training programmes
Prospective Nursing Associates
People cared for by Nursing
Associates

18. Quality Assurance exercise

19. 1. To gain a deeper understanding of how
the curriculum framework is working ‘in
action’.
2. To identify variation between and within
test sites and consider what is
warranted and what needs to be
addressed.
3. To provide assurance to the trainees,
the test sites and the NMC that we are
going to produce Nursing Associates
who can enter the register with minimal
adjustment.
Why undertake a QA exercise?

20. Developing the QA tool
HEE commission OPM to support the workstream
Working group (HEE, OPM, NMC) develop survey
questions
Survey questions tested with an HEI and a test site
Questions and guidance completed
Survey completion: first three weeks of November
Analysis: Nov / first half of December
Action plans drafted where needed
Draft report produced: mid-December
Final report produced – end of December
October
November
December

21. Thank you
Professor David Sines
Chair of the Nursing Associate Scrutiny Group
Sam Donohue
Senior Nurse, HEE

22. Panel Discussion

23. Panel Session
Lord Willis of Knaresborough
Jackie Smith, Chief Executive, Nursing & Midwifery Council
Professor Lisa Bayliss-Pratt, Chief Nurse, Health Education England,
Avril Devaney, Director of Nursing, Cheshire and Wirral Partnership NHS
Foundation Trust
Dr Melaine Coward, Head of School, University of Surrey
Alice Potter, Trainee Nursing Associate, East Midlands Collaborative,
Martyn Davey, Trainee Nursing Associate, Somerset Nursing Associate
Partnership
Ian Prince, Patient Representative, East Midlands Collaborative

24. Florence Nightingale
had a pet owl called
1. Athena
2. Crimea
3. Chardonnay
Question 1

25. Answer:
Athena

26. Question 2
The main reason for
dental visits over
Christmas is
1. Biting on a sixpence
in a Christmas
pudding
2. Eating walnuts
3. Getting the top off a
whisky bottle

27. Answer:
Walnuts

28. Question 3
Why nursing associates?

29. Question 4
When were
prescription charges
introduced in the
NHS?
1. 1952
2. 1971
3. 1989

30. Answer
1952

31. Question 5
Why regulate the role?

32. Question 6
1. India approx. 100 BCE
2. Greece approx. 500 BCE
3. The UK 1812
“ A nurse is required to be knowledgeable,
skilled at preparing formulations and
dosage, sympathetic towards everyone,
and clean. ”
This guidance is from

33. Answer:
India

34. Question 7
What are the benefits of
the Nursing Associate
role to the patient and
the NHS (health and care)
in general?

36. Lunch & Refreshments
Workshops commence 13:25pm
Workshop 1 – Crown Suite
Workshop 2 – Cornwall Suite
Workshop 3 – Grand Hall

37. Sir Keith Pearson
Chair, Health Education England

38. Learning together
Rebecca Davies – Trainee Nursing Associate
Nothando Tshuma – Student Nurse

39. About the course
• Students should be in employed with one of the course
employee partners
• Commenced January 3rd 2017
• 45 weeks a year over 2 years
• Attend university one day each week (two days for the
first eight weeks to develop academic skills)
• Working towards six modules each year, worth 20 credits
each
• Modules are designed to meet requirements of:
• QAA UK Quality Code for HE – Characteristics
Statement Foundation degree (2015)
• QAA Subject Benchmark Statement for Healthcare
programmes (2001)
• HEE Nursing Associate Curriculum Framework (2016)
• NMC pre registration standards for education (2010)
• Leeds Beckett Education Strategy (2016)

40. Course delivery
The course at Leeds Beckett
University mirrors the first two years
of the undergraduate nursing
degree.
Due to the time constraints of being
informed of the course going ahead
and delivery, a decision was made
to design the course around the
undergraduate modules.
Most lectures are delivered to
trainee nursing associates and BSc
(Hons) Nursing students together.

41. Benefits of learning together
Learning together is reflective of multi
disciplinary working in practice. Other health
professionals learn together; for example, mental
health nursing and adult nursing.

42. Benefits of learning together
Allocating student nurses to placement areas
that have a trainee nursing associate in the
team allows the two roles to learn from each
other in practice. Student nurses benefit from
seeing how trainee nursing associates work in
practice, and how we contribute to the health
care team.

43. Benefits of learning together
Providing reassurance and confidence to
registered professionals that trainee
nursing associates are receiving a high
standard of education; and that they work
in line with key competencies and core
values of the registered nurse.

44. Both the student nurse and trainee nursing
associate are working towards the same goal.
We are both working for the benefit of our patients
and service-users. We strive to provide high
standards of person-centred and holistic care to
those individuals under our care.

45. Learning Together
Nothando Tshuma
January Cohort 2017
Student Nurse
Thank you for the invitation
It is a great opportunity for my cohort of student
nurses to be a part of such an important move in
the healthcare industry

46. Learning Together
Student Nurse
Most student nurses have less experience of
working in clinical practice, e.g.
Personal Background
Nursing Associates have a great deal of clinical
expereinces and they share their knowledge
with us e.g.
Group work - shared experiences

47. Learning Together
Benefit
Sharing experiences and learning
brings us together creating
relationships and understanding.
e.g. when we started the course there was a division
between the two groups NOW we are ONE COHORT
learning together.

48. Learning Together
Benefit
Nursing Associates are so knowledgeable
about the practice setting and they share their
knowledge with us.
This helps us to have an understanding of
what to expect in practice.
Proven to be so helpful.

49. Learning Together
The nursing associates are already working with
nurses in the field and when they share some of
the bad habits with us e.g. Abbreviations
This Will
Raise awareness of poor practice to empower us
to provide safe, efficient, patient-centred care.

50. Learning Together
Limitation
We would love to know the Job Description for
the Nursing Associates.
This will help us understand how they bridge
the gap between registered nurses and
healthcare assistants.

51. Learning Together
Learning together benefits patients
We provide a holistic approach from the same
knowledge base.
Learning together helps us form collaborative
relationships in practice.
 We need to achieve the same standard of
academic attainment.

52. THANK YOU !

53. 22 November 2017
Showcase, Celebrate and Share Progress
PRESENTATION BY:
Anna Beckett, OPM Group
Evaluating the impact
of Nursing Associates
Emerging findings

54. Project background
OPM Group is conducting a
2-year process and impact
evaluation of the introduction
of Nursing Associates, with
4 waves of surveys and
interviews.
This presentation reflects
the results of wave 1.
N = 1030 trainees participated in our survey to date (53%)
Interviews and focus groups with trainees, stakeholders and staff
across 4 test sites:
East
Midlands
Collaborativ
e
Somerset
North East
London
Lancashire
and South
Cumbria

55. What we have learned so far
EXPERIENCES OF ACADEMIC LEARNING
EXPERIENCES OF WORK-BASED LEARNING
WHAT’S ENABLING PROGRESS?
EMERGING IMPACTS

56. Academic learning
Overall good levels
of satisfaction with
quality of teaching
and level of support
provided by HEIs
Overall good levels
of satisfaction with
quality of teaching
and level of support
provided by HEIs
Trainee Nursing
Associates are
highly motivated
and conscientious
learners who
bring lots of
experience with
them
A focus on the
building blocks has
been crucial to help
TNAs to prepare
and manage
programme
demands
TNAs have found
the programme
demanding and
frequently requested
more protected time
each week to do
academic learning
?
Academic learning

57. What we have learned so far
EXPERIENCES OF ACADEMIC LEARNING
EXPERIENCES OF WORK-BASED LEARNING
WHAT’S ENABLING PROGRESS?
EMERGING IMPACTS

58. Work-based learning
TNA progress supported
by planning and goal-
setting, with TNAs
becoming clearer and
more assertive about their
learning needs as they
move through programme
Growing confidence
and clarity from
supervisors and wider
colleagues in base and
placement settings
about how to support
TNAs effectively
Variation in the
organisation of
placements by different
test sites, highlighting
the need for phase of
quality assurance
?

59. What we have learned so far
EXPERIENCES OF ACADEMIC LEARNING
EXPERIENCES OF WORK-BASED LEARNING
WHAT’S ENABLING PROGRESS?
EMERGING IMPACTS

60. Factors helping trainees progress
High levels of cohesion and support between TNAs1
2
3
TNAs’ readiness to take up learning resources and
support available through HEIs
Support provided by clinical educators and HEI tutors

61. Areas to consider for further improvement
Consider opportunities
to streamline the
workload associated
with the programme
1 2 3
Continue push to
promote awareness
and understanding
about new role and
training programme
Address unwarranted
variation in the TNA’s
work based learning
experience

62. What we have learned so far
EXPERIENCES OF ACADEMIC LEARNING
EXPERIENCES OF WORK-BASED LEARNING
WHAT’S ENABLING PROGRESS?
EMERGING IMPACTS

63. TNAs’ growing
confidence and
self-belief
“I feel a bit more confident
using my professional
judgement now that I have
some knowledge behind me, I
feel a greater sense of
responsibility, this is really
good for patients, and I am
asking them more questions,
how it feels for them.”

64. ... which is widely
recognised by
colleagues and
faculty
“The main success I would say
is the change in their aptitude
and insight - that was the
biggest change, the way they
support and develop each
other.” (HEI lead)
“Five months down the line
they are thinking more like a
nurse” (Supervisor)

65. Shift from a ‘task-
focused’ role to
patient and
outcomes-focused
role
“I feel more like an
ambassador for the
patients since I
became a trainee
nursing associate.”

66. Placements are
supporting an
exchange of skills
and knowledge
“Working in a neurology
department I shared an
observation that there was a
lack of interaction with patients
– the next day staff were
greeting and engaging patients
better, I could see the
difference this had made.”

67. … which is leading
to improvements
in the quality of
care delivered to
patients
“During my placement, good
care ticks went up by 43%, the
department also saw letters to
the matron (complaints) go
down. This was achieved by the
relationships and joint
working between the nurses
the TNA.”

68. Next steps
Year 1 evaluation report
in early 2018
1
2
3
Quality assurance exercise
to be completed end of 2017
Next survey to be launched in Jan 2018 further
deep dives planned which will
incorporate patient feedback

70. Countdown to regulation
Emma Westcott
NA programme lead
HEE conference
22 November 2017

72. Countdown to regulation
Emma Westcott
NA programme lead
HEE conference
22 November 2017

73. Objectives of the session
• Timeline for regulation
• Preparing for regulation
• Managing the first cohorts of NAs on to the
register
• Personal reflections

74. Countdown to regulation
• NMC asked by SofS to regulate NA, and agreed
• We are the ‘regulator-in-waiting’
• Changing our legislation usually takes 18-24m
• We hope legislative change will have happened
by July 2018

75. Jan 17
Sept 17
First NAs begin training.
NMC agrees to regulate NAs
NMC publishes early working draft of NA
standards of proficiency
Dec 17 NMC consults on the fees for nursing associates
July 18 Legislation change complete
September 18
Jan 19 New NA part of NMC register opens
Council approves Code, standards, requirements
March 18
NMC consults on Code, standards of proficiency
and education programme requirements
Timeline: key dates

76. Preparing for regulation
• Trainees:
• You have plenty to do on your programmes!
• Read the draft standards of proficiency
• Familiarise yourself with the Code
• Respond to the consultations, if you have time
• We will let you know in good time about how to
register
• Sign up for our TNA newsletter

77. Preparing for regulation
• Test site partners:
• Participate fully in HEE’s QA work
• Look at draft standards and requirements
• Think about when you want to get your NA
programmes approved
• Ensure your trainees know the Code, understand
professional regulation, and are revalidation-
ready
• Think forward to registration requirements

78. Plans for the first NA cohorts
• Regulating new groups – regulator must decide how to
open register to legitimate ‘legacy’ applicants
• Plan in place for obtaining assurance about the
programmes we will inherit – HEE QA
• We are asking test sites to assess trainees against our
standards of proficiency
• If we have assurance about programmes AND trainees
meet our standards, applicants will be treated as if they
have graduated from an approved programme
• Test of competence available for others as a route to the
register

79. Reflections

80. Q&A

81. Thank you

82. Professor Lisa Bayliss-Pratt
Chief Nurse, Health Education England

83. Professor Lisa Bayliss-Pratt
Chief Nurse, Health Education England

85. Look how far we’ve come

86. Louis Pasteur’s theory of germs is ridiculous fiction
PROFESSOR OF PHYSIOLOGY PIERRE PACHET, 1872
Heavier than air flying machines are impossible
LORD KELVIN, 1895
Computers in the future will weigh no more than 1.5 tons
POPULAR MECHANICS, 1949
We don’t like their sound and guitar music is on the way
out
DECCA RECORDING COMPANY ON THE BEATLES, 1962
Predictions are usually spot on…
?

88. Today has not only been about
celebrating and sharing progress
but saying
THANK YOU!